In recent years, a number of articles have been published on the epidemiology of methicillin-resistant strains acquired in the Staphylococcus aureus (MRSA) community, while the treatment of infections caused by them in children has not been fully studied. The question of the possibility of conducting therapy on an outpatient basis, the need to prescribe antibiotics is still debatable, the drugs of choice in the treatment of this group of infections have not been determined.

A prospective study by Mr. Lee and colleagues (United States) involved children with subcutaneous tissue abscesses caused by strains of MRSA acquired in the community and treated on an outpatient basis. Between May 2002 and February 2003, 70 children were examined. All patients received antibiotic therapy, in addition, in 92% of patients, drainage of abscesses was carried out, in 66% of cases - a bandage.

All strains isolated from MRSA were sensitive to rifampicin, trimethoprim / sulfamethoxazole, gentamicin, vancomycin, 61% were sensitive to clindamycin, 13% to erythromycin. Only in 7.5% of patients, the antibiotics prescribed before the culture study were active against the isolated strains. In 54% of patients, the antibiotic was not replaced by a more effective medication.

On repeat visits on days 1 to 6 and 6 to 9, clinical improvement was observed in 87% and 98% of the patients, respectively. Only 4 patients (6%) had to be hospitalized and, in all of these patients, the strains causing the infection were insensitive to the prescribed antibiotic. The predisposing factors for hospitalization were the use of intravenous antibiotics at 1 visit (p = 0.04) and the area of skin lesion was greater than 5 cm (p = 0.002).

No serious complications or serious undesirable effects were detected during the study and follow-up for 2 to 6 months. In 4.3% of patients, relapses of infection were observed.

Based on the above, the authors conclude that pustular infections in children caused by community acquired MRSA strains tend to disappear after autopsy and drainage, despite ineffective antibacterial therapy. Thus, in most cases with this pathology, antibacterial treatment with adequate autopsy and drainage is not necessary.